Dragon blood may help wounds heal faster

synthetic peptide heal komodo dragon

A new study has identified a peptide, derived from the Komodo dragon, called VK25, which can be synthesized and used as an antimicrobial peptide to promote wound healing.

The new research has identified (see below) a peptide found from the Komodo dragon (Varanus komodoensis), called VK25, which appears to be useful as a cationic antimicrobial peptide (CAMP). There is currently considerable interest in antimicrobial peptides in a world where antibiotic effectiveness is in decline. These peptides are potent, broad spectrum antibiotics which demonstrate potential as novel therapeutic agents. (more…)

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Atrium Medical Center division earns award for clinical excellence

atrium wound care division

MIDDLETOWNThe Wound Care Center and Hyperbaric Services at Atrium Medical Center recently was recognized with a national award for clinical excellence.

The Center of Distinction Award was presented by Healogics, the nation’s leading and largest wound care management company. The center was also honored with the Healogics President’s Circle Award.

The awards recognize outstanding clinical outcomes for 12 consecutive months, including patient satisfaction higher than 92 percent, and a wound healing rate of at least 91 percent in less than 31 median days. (more…)

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Morrison Community Hospital offers specialized Wound Care

Morrison Community Hospital Wound Care

Wound care is a specialized form of treatment that focuses on helping patients recover from all types of wounds, both acute and chronic (ongoing).  The most common types of wounds are those that result from acute injuries, surgical procedures, diabetes, and pressure or bed sores.  Wounds can also result from radiation procedures that are part of a treatment plan for cancer, and they can be a result of vascular disorders. (more…)

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Think a Patient Has Rights? They Left.

Patient Rights

by Dr. Michael Miller

There are few absolutes in my universe. I know that my youngest daughter will gleefully and with full malice (but humorously presented) find something to torment me about every time I see her; referrals from family practice docs arrive well marinated in multiple antibiotics with nary a diagnosis in sight (save for the ubiquitous “infection”); and that regardless of what I recommend, offer, beg, plead, or cajole, that the patient has the complete and total power to make their decisions regarding their care and who provides it. Unless they are deemed by multiple authorities to be incapable of making a decision, until the appropriate paperwork or an emergency situation exists mandating immediate lifesaving action, the ball bounces squarely in their court…or so I thought. (more…)

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If All You Have is a Hammer, What Happens When You Run Out of Nails?

hammer

by Dr. Michael Miller

Over the years of making house calls for wound care, I found that there was a real need for home based mental health and behavioral care, palliative care, podiatry and lots of other things. We cater to those who are home bound based on the classic definition involving the word “Taxing”. One of the more prevalent problems affecting all patients involves the nebulous but ubiquitous, nerve jangling, aptly named, “5th Vital Sign”, namely pain. As a part of my medical group, we have created a program that provides pain management not just to the home bound but all those whose lives and lifestyles are affected adversely by it. The program is a monument to government bureaucracy involving multiple layers of paperwork, mental health evaluations, testing of bodily fluids for both illegal and legal substances and then, the actual evaluation of the patient commences. After all hurdles are vetted and then jumped, then and only then does a prescription for the appropriate nostrum leave the pad. In wound care, we treat based on the etiology, the location, the related factors, the amounts of drainage, the surrounding tissues and so on, ad nauseum. Not surprisingly, in pain management, the scenario is much different. In wound care the mantra of the dabbler is see the hole, fill the hole. In pain management, the goal is to minimize pain to maximize functionality but the overriding questions are how this is accomplished. (more…)

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Don’t Kid Yourself, Amputation Is Unquestionably A Failure

amputation is a failure

by Dr. Michael Miller

I recently saw an ad for a pending lecture at a national conference that piqued my interest much like “deflate-gate”.  The title of this lecture horrifically touted that Amputation need not be considered failure.  As a full time wound care doc, I work to identify those conditions that place patients at risk of all consequences both limited and catastrophic.  We use the catchy title of “Limb Preservation”.  We start the process by engaging in the unusual behavior of making definitive diagnoses, then systematically address them in as comprehensive manner as possible.  I am proud to tell you that while there are occasions in which a terminally damaged digit is lost,  that we have rarely sacrificed the greater part of a foot and more, have had only 3 lower extremity amputations in the last 5 years on patients who’s care remained exclusively with us.  Of course, when a patient for whom we have created and implemented a “Limb Pres” care plan is taken out of our system (usually via a hospitalization for a reason other then the lower extremity problem), the facility forces that be unfortunately but infrequently demonstrate their inadequacy and paranoia by gang-harangueing the patient and family.  They are lambasted with lurid tales of the condition marching up the leg engulfing the foot, knee, torso, and brains much like a flesh-eating PacMan.   The patient’s confidence now neutered has little chance against this persistent onslaught of inadequacy and so, much like the Queen song, “Another One Bites The Dust”. (more…)

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Wound care treatment explained at Rotary

Wound Care Solutions at Community Hospitals and Wellness Centers-Bryan

When treating people for wounds, the care team preforms both a comprehensive diagnosis and comprehensive treatment, Kathy Khandaker, director of wound care at Community Hospitals and Wellness Centers-Bryan, told the Bryan Rotary Club at its Friday meeting.

The wound care clinic opened at CHWC in 2006, added ostomy care in 2007, continence care in 2010 and added a full-time physician in 2015. The care team includes a wound care nurse, a hyperbaric oxygen therapy technician and a receptionist in addition to the physician. (more…)

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Breaking silos: Effective wound healing means treatment across the continuum

Around 6.5 million patients in the U.S. suffer from chronic wounds, such as pressure injuries or ulcers. Treatment costs $25 billion each year, representing a sizable and growing problem. Despite the wide impact of chronic wounds, it’s rare to see specialized, effective wound care delivered across the care continuum.

A chronic non-healing wound is a surrogate marker for illness. These patients require holistic management of their co-morbidities and continuity across care settings.

Despite this, a great deal of emphasis has been placed on treating wounds as singular events, managed topically with expensive dressings and support surfaces. This is only a small part of wound healing.

As a physician focused solely on wound care, I have learned that we must shift the focus from simply treating the wound to treating the wounded patient. The impact in the post-acute care setting in particular is worthy of evaluation and discussion, as up to 29% of patients in long-term care facilities will experience a pressure ulcer, posing serious legal, financial, and staffing implications.

For those providers working outside long-term care, there is little understanding of challenges facing LTC providers. Acute providers do not often ask, for example, how are my LTC partners reimbursed? How are they staffed? What are the requirements and regulatory pressures they face? Asking these questions would facilitate a more productive dialogue with a focus on collaborative prevention, rather than waiting until a chronic wound occurs in the LTC setting.

Creating an integrated wound care community

To address the needs of the present and growing population of patients with chronic wounds, Healogics developed an integrated wound care community model, to coordinate the wound healing process across all care settings. The program utilizes Healogics Specialty Physicians, a subspecialty group of physicians and providers with extensive training solely focused on wound care.

HSPs provide expert inpatient consultation and ensure safe transition of patients out of the hospital into the appropriate care setting. Because HSPs see the patient regardless of post-discharge venue, patients receive the same quality of care whether they are going home, to a skilled-nursing, assisted living, or LTC setting. Because chronic wounds are surrogate markers for illness, we have realized it’s essential to have an integrated, multi-setting, and multi-disciplinary process to treat the patient and their co-morbidities.

Data collected at a pilot IWCC site in the Midwestern U.S. from 2014 to 2016 revealed very positive trends for chronic wound patients. In the acute care setting, the average length of stay decreased from 9.41 days to 5.64 days, and total cost of care per patient was reduced from $10,670 to $7,248.

We’re excited by these promising results, which were revealed at the American College of Wound Healing and Tissue Repair Conference last December. We look forward to refining and expanding the model by helping our partners in acute and LTC settings standardize their practices, use evidence-based clinical guidelines, mobilize technologies and processes, and pay critical attention to patient safety and value-based outcomes.

When it comes to wound healing, no venue of care should operate alone—an integrated solution that creates continuity for the patient is critical. There are four things LTC facilities can do to break down the silos:

Read more at McKnight’s

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Accuracy of the Ankle-brachial Index in the Assessment of Arterial Perfusion of Heel Pressure Injuries

Abstract: Background. The evaluation and treatment of heel pressure injuries are a significant and expensive sequela of the aging population. Although the workup of patients with lower extremity tissue loss usually involves an assessment of the arterial blood flow by means of noninvasive vascular testing, the results may be misleading in patients with heel pressure injuries when the ankle-brachial index (ABI) does not provide direct information about perfusion of the rearfoot. The objective of this retrospective, observational investigation was to determine if noninvasive vascular testing provides accurate and reliable results in patients with heel pressure injuries. (more…)

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Skin substitutes: Understanding product differences

Skin substitutes (also called tissuebased products and dermal replacements) are a boon to chronic wound management when traditional therapies have failed. When selecting skin substitutes for their formularies, wound care professionals have many product options—and many decisions to make.

Repair of skin defects has been a pressing concern for centuries. As early as the 15th century BC, Egyptian physicians chronicled procedures and herbal treatments to heal wounds, including xenografts (skin from another species). The practice of applying allografts (human cadaver skin) to wounds was first documented in 1503. In 1871, autologous skin grafting (skin harvested from the the person with the wound) was tried. Next came epithelial- cell seeding, which involves scraping off the superficial epithelium of healthy skin and transplanting the cells onto the wound. (more…)

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Clinical Notes: Healing SCI Patients, antiseptics on mahout, diabetes

Electrical stimulation

Electrical stimulation and pressure ulcer healing in SCI patients

A systematic review of eight clinical trials of 517 patients with spinal cord injury (SCI) and at least one pressure ulcer indicates that electrical stimulation increases the healing rate of pressure ulcers. Wounds with electrodes overlaying the wound bed seem to have faster pressureulcer healing than wounds with electrodes placed on intact skin around the ulcer. (more…)

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Hyperbaric oxygen therapy as adjunct therapy for wound care

hyperbaric oxygen therapy

Why would a patient with a wound spend almost 2 hours a day, 5 days a week, in a locked chamber receiving 100% oxygen? The answer is that medical grade hyperbaric oxygen therapy (HBOT) can be a valuable adjunct therapy for selected types of wounds.
In this article, I’ll focus on hospitals and clinics that follow guidelines from the Undersea & Hyperbaric Medical Society as I give you a brief overview of how HBOT works and its use in wound care. (more…)

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